ISSUE: Nurses are well aware that one of the many occupational
hazards of their profession are needle sticks and the risk of
contracting, inter alia, hepatitis C. In this unusual Arkansas case, the
courts were confronted with the question of whether a nurse who had
sustained a needle stick 23 years earlier had a bona fide Workers'
Compensation claim when she was diagnosed as having hepatitis C 23 years
after the needle stick. Was the hepatitis C an occupational disease? Was
the nurse entitled to Workers' Compensation benefits 23 years after
the needle stick.

CASE FACTS: Sheila Young sustained a needle stick while employed by
Cross County Hospital where she worked as a nursing assistant from July
1975 until January 1977. The hospital was made aware of the incident.
Although no claim was made for Workers' Compensation at the time,
Sheila Young was hospitalized in November 1975. Discharge statements
indicated that she had been exposed to an infectious hepatitis patient
six weeks earlier. Hospital records also showed that although her
bilirubin was normal upon admission, her SGOT and her SGPT (liver
enzymes) were elevated, and she had a history of nausea, pain in the
lower back, weakness, fatigue, and lethargy. She was discharged with a
final diagnosis of "sinusitis." From 1993 through 1997, she
complained of feeling bad and underwent repeated SGOT and SGPT tests.
The results from each of those tests were abnormal. In December of 1998,
a liver biopsy confirmed that she suffered from hepatitis C. On December
9, 1998, she filed a claim for Workers' Compensation benefits on
the grounds that she had sustained a work-related injury associated with
hepatitis exposure in 1975. An Administrative Law Judge (ALJ), applying
the Workers' Compensation laws in effect in 1975, held that the
claimant's hepatitis C condition was an occupational disease or
infection, and her claim for benefits was barred by the statute of
limitations. In making her decision, the ALJ relied on Arkansas law,
which provided, in pertinent part, that "the following diseases
only shall be deemed to be occupational diseases ... Infectious or
contagious disease contracted in the course of employment in, or in
immediate connection with, a hospital or sanatorium in which persons
suffering from such disease are cared for or treated." Further, the
ALJ found that the applicable statute of limitations governing the claim
was two years. The full commission affirmed the decision of the ALJ and
adopted that decision. Sheila Young appealed.

COURT'S OPINION: The Arkansas Court of Appeals affirmed the
judgment of the Workers' Compensation Commission. The court held,
inter alia, that the definition of "occupational disease"
applied in this case. Because the definition of occupational disease
fails to draw a distinction between infectious diseases incurred by a
single exposure as opposed to infectious diseases incurred by numerous
exposures, the court concluded that the circumstances alleged by the
claimant described an "occupational disease" and not an
"injury." The court further noted that a claim for an
occupational disease is barred unless filed within two years from the
date of the last injurious exposure. The court observed that the
claimant acknowledged that her last exposure to the hepatitis C patient
was in 1975. There was no evidence of any other similar exposure during
the course of employment.

LEGAL COMMENTARY: This case illustrates the significance of noting
any work-related incident or injury. Out of an abundance of caution,
nurses should always file a formal notice of any work-related injury
with their employer. If the claimant in this case had, in fact, filed a
notice of her claim within two years of the needle stick which occurred
back in 1975, she would have complied with the applicable two-year
statute of limitations for filing a Workers' Compensation claim.
Consequently, any recurrent disability arising from that claim might
entitle her to benefits. In many states once a claim is filed, the
claimant establishes, by operation of law, the fact that for the next
ten (in some states) years if there is any disability which can be
directly attributed to having been caused by the injury, the disability
would be compensable under Workers' Compensation law. So too, the
costs of any and all necessary medical care and treatment would be
covered under Workers' Compensation. Accordingly, nurses are urged
to follow the philosophy that if an injury is sustained in the course of
work, however innocuous it might appear at the time, they should file a
timely notice to secure their rights under the applicable Workers'
Compensation law. There need not necessarily be any disability or
medical costs incurred. However, the fact that an employee can show that
he or she was injured in the course of his or her employment may ensure
their entitlement to Workers' Compensation benefits years later.
Unfortunately, many employees are reluctant to file any such claims for
fear of jeopardizing their position with an employer. When in doubt,
file!

Meet the Editor & Publisher: A. David Tammelleo, JD. is a
nationally recognized authority on health care law. Practicing law for
nearly 40 years, he concentrates in health care law with the Rhode
Island law firm of A. David Tammelleo & Associates. He has presented
seminars on medical, nursing and hospital law throughout the United
States. In addition to his writings as Editor of Medical Law's,
Nursing Law's & Hospital Law's Reagan Reports, his legal
articles have been published in the most prestigious health law
journals. A prolific writer, his thousands of articles, as well as his
achievements as an attorney and lecturer, have won him recognition in
Martindale-Hubbell's Bar Register of Preeminent Lawyers and Marquis
Who's Who in American Law.

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